Anzac Student Tour 2006

Anzac Student Tour 2006

Student Entry and Declaration

  • An electronic version of this form is available at
  • All students who have an entry forwarded to the judging panel will be provided with a Certificate of Participation.
  • A completed Student Entry and Declaration form is to accompany each entry submitted to the 2018 Premier’s ANZAC Spirit School Prize judging panel.
  • Onlyfiveentries will be accepted from a school.Schools are advised to follow the judging criteria in determining their best five entries.
  • All students must be in Year 9 or 10 in 2018.
  • Transcripts of the winning entries become the property of the Government of South Australia.

Please complete all sections neatly and clearly on thisStudent Entry and Declaration and attach securely to the student entry.

Student Surname: / Given Names: / Gender / Date of birth
Male/Female
Home phone number / Student mobile number / Email
Year Level (Please tick): /  Year 9 in 2018 /  Year 10 in 2018
Please indicate whether this entry was developed :
as part of a class activity? / Yes/No / If yes, how many students in the class? / as an individual activity? / Yes/No
Father’s name: / Father’s Mobile phone number / Email
Mother’s name / Mother’s Mobile phone number / Email

Home Address:

No: / Street Name:
Suburb or Town: / Post Code:

Postal Address (if different from home address):

Post Office / Box number
Suburb or Town: / Post Code:

School Details

School Name:
Contact/Support Teacher:
Postal Address: / Suburb or Town: / Postcode:
Telephone No: / Facsimile No: / School Email:

Principal Declaration

I am fully aware of the conditions of entry and the prize in this competition and support the entry of the above-named student. I am aware that successful students may be offered a place in a study tour to Vietnam in 2018representing South Australia.

Principal’s Name Printed: / Principal’s Signature: / Dated:
/ /2018

Student Statement

This can be a typed or handwritten statement(maximum500 words) or a 2 minute audio or video and must accompany the entry.

This statement provides you with the opportunity to share with the judging panel as much information as

possible relating to:

  • your involvement in the community
  • extra-curricular contributions to the school
  • your interest in history
  • other personal information relevant to the judging process.

I understand that my entry becomes the property of the Government of South Australia and may be

used for promotional purposes in relation to the Premier’s ANZAC Spirit School Prize.

Student’s Name: / Student’s Signature: / Dated:
/ /2018

Teacher Statement of Authenticity

I hereby declare that the application is the original work of the entrant, to the extent that others provided no more than usual guidance.

Contact/SupportTeacher’s Name: / Teacher’s Signature: / Dated:
/ /2018

Parent/Guardian Consent

I am fully aware of the conditions of entry and the prize in this competition and support the entry of the above-named child. I am aware that successful students may be offered a place in a study tour to Vietnam in 2018representing South Australia.

I give consent for………….……………………………………… to participate in the competition.

Parent/Guardian Name Printed: / Parent/Guardian Signature: / Dated:
/ /2018

Return this entry and declaration form by post, with the student entry to:

Attention: Malcolm McInerney

2018 Premier’s ANZAC Spirit School Prize Application

Department for Education and ChildDevelopment

Learning Improvement Division

GPO Box 1152

Adelaide SA 5001

Further enquiries or information on the 2018 Premier’s ANZAC Spirit School Prize please contact:

Malcolm McInerney

2018Premier’s ANZAC SpiritSchool Prize

Phone: 0437249200

email:

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